Black Lives Matter: What’s PrEP got to do with it? The State of AIDS in Black America 2016

LOS ANGELES — Today the Black AIDS Institute, in partnership with Gilead Sciences, is releasing its 2016 report on the State of AIDS in Black America: “Black Lives Matter: What’s PrEP Got to Do With It?” The report focuses on what Black communities need to know about pre-exposure prophylaxis (PrEP) and other new biomedical HIV prevention tools.

Many scientists, doctors and advocates believe that the scientific tools needed to end the AIDS epidemic already exist. Unfortunately, as the persistently unacceptable high rates of new HIV infections underscore, these tools are not being applied effectively in Black communities. While new HIV diagnoses in the U.S. as a whole fell 19 percent between 2005 and 2014, new cases among Black gay and bisexual men, for example, increased by 87 percent.

When used correctly, PrEP has been shown to reduce the risk of acquiring HIV by over 90% for HIV-negative individuals with an HIV-positive partner; however, it is still being underutilized in Black communities.

“The new bio-medical prevention tools will either reduce HIV health disparities or exacerbate them,” says Black AIDS Institute President and CEO Phill Wilson. “Some communities are rapidly adapting to a new world where bio-medical tools to fight HIV are used to dramatic positive effect, but Black communities are not. This report investigates why.”

“The report examines where Black communities are in familiarity, understanding, knowledge, beliefs, access and utilization of PrEP. It also makes recommendations on how the community can maximize the potential benefits of PrEP and other biomedical interventions,” Wilson adds. “But most importantly, this report provides resources to help educate communities about PrEP and help communities access and finance PrEP. Finally, this report makes recommendations on how Black communities can maximize the potential benefits of PrEP and other biomedical interventions.”

The report’s key findings include the following:

PrEP works. Research studies and demonstration projects have shown that PrEP is extra-ordinarily effective when used as directed. Protection against HIV infection approaches 100 percent for people who take PrEP as prescribed. “In 2014 I saw a big increase in demand for PrEP,” says HIV specialist and researcher David Male-branche, M.D., MPH. “When you teased out the study results, it became crystal clear. Among people who took Truvada every day, no one got HIV.”

PrEP can help end the AIDS epidemic in Black America. On its own, PrEP can prevent 1 in 5 new HIV infec-tions through 2020. Combined with scaled-up HIV treatment, PrEP could avert 70 percent of all new infections over the next five years.

Black America needs PrEP the most. America’s HIV epidemic is a Black epidemic. Black Americans make up 49 percent of all new HIV diagnoses. Black gay and bisexual men stand a 50 percent chance of acquiring HIV in their lifetimes, Black women are 18 times more likely than White women to be HIV positive, and Black transgender women are three times more likely to acquire HIV than their White or Latina counterparts.

When it comes to PrEP, Black America is being left behind. Every available measure indicates that while Black communities need PrEP the most, they are far less likely to receive PrEP than other racial or ethnic groups. “Because PrEP is new, there is a lot of work to do to get it implemented, particularly in communities at highest risk,” says Dawn Smith, M.D., MPH, an epidemiologist in the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention.

New scientific evidence suggests that robust PrEP uptake is achievable in Black America. New clinical trial findings indicate that programs that are tailored to the needs of Black gay and bisexual men and that proactively address barriers to uptake and adherence can promote strong PrEP utilization in Black communities. “There needs to be a shift in the ways in which we are advertising PrEP,” says Leo Moore, M.D., an HIV doctor who has prescribed PrEP to about 50 patients. “Some of the advertisements I’ve seen don’t speak to men of color. But we know the epidemic is largely in men of color. We need a brain shift to develop ad campaigns and messages that focus on the people who present the greatest need.”

An urgent national initiative is needed to expedite the uptake of PrEP in Black America. The ongoing AIDS crisis in Black America necessitates an urgent national initiative—one combining the efforts of policy-makers, funders, public health agencies, health-care providers, community organizations and Black communities. “People were being made aware of PrEP but had no place to access those services,” says Leisha McKinley-Beach, HIV prevention program administrator for the Fulton County Health Department in Georgia. “Prior to the health department providing PrEP, there were perhaps two for-profit clinics where you could get PrEP. But to access PrEP at the private clinics, you had to have insurance or the ability to pay out of pocket.”

The Report concludes with seven key recommendations:

Invest in community education and awareness campaigns.

Educate health-care providers about PrEP.

Adapt delivery systems to facilitate PrEP uptake.

Remove financial barriers to PrEP use.

Undertake specific efforts to address the PrEP needs of cisgender and transgender women.

Strengthen the ability of PrEP programs to maximize STI control.

Continue to pursue a robust research agenda on PrEP.

The report is available online at blackprep.org.

The Black AIDS Institute

Founded in 1999, the Black AIDS Institute is the only national HIV/AIDS think tank in the United States focused exclusively on Black people. The Institute’s mission is to end the AIDS epidemic in Black communities by engaging and mobilizing Black institutions, leaders and individuals in efforts to confront HIV/AIDS. The institute disseminates information, offers training and capacity building, provides testing and linkage to care, influences both private and public HIV/AIDS policy, and conducts mobilization and advocacy from a uniquely and unapologetically Black point of view. For more information about the Black AIDS Institute, go to www.BlackAIDS.org